Individual
PAUL EDWARD CULLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 BERRYWOOD DR, COLUMBIA, TN 38401-6409
(931) 381-7766
(931) 381-2738
Mailing address
105 BERRYWOOD DR, COLUMBIA, TN 38401-6409
(931) 381-7766
(931) 381-2738
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS3661
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010342
TENNCARE
TN
01
—
3072215
BLUE CROSS BLUE SHIELD TN
TN
01
—
80-40025
UNITED HEALTHCARE
TN
01
—
909843
UNITED CONCORDIA
TN
Enumeration date
07/26/2006
Last updated
11/11/2011
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